However this does not always work: many people have a mobile right lower
quadrant and the structures can move. A technique that works consistently is to "run" the large bowel from the rectum to the cecum.
(Surgeons "run" the bowel with their hands. The CT scanner is cleaner and
less malodorous.) Start at the anus, scroll through the rectum, up through the
sigmoid colon and descending colon. Follow
the lumen of the bowel up and down as you need to. Don't skip segments. Identify
the splenic flexure, traverse rightwards along the transverse colon, then follow
the ascending colon to the ileocecal valve. The valve is easy to find because a
loop of terminal ileum will merge with the colon. Follow the lumen of the colon past the ileocecal valve
into the cecum. The origin
of the appendix is located on the same side of the cecum as the ileocecal valve. If the cecum has
flipped this area may be superior to the valve, not inferior.
However, its origin will be opposite the ileocecal valve from the ascending
colon. Once the appendix leaves the cecum it can travel in any direction.
Coronal images often help with visualization, but I am rarely unable to find the
appendix on the axial images. Using this method I can almost always find the appendix quickly. I
also know that I have evaluated the entire bowel for other things like colitis
or diverticulitis.

Go back to the cine and trace
the bowel from anus to cecum. You can easily find the
ileocecal valve. The
ascending colon is above this level. The cecum is below. The
appendix originates in the
expected location.